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Sunday, 11 January 2009

ON Friday, as I left work and headed out to Buckinghamshire, I grabbed a copy of the free newspaper, London Lite. I usually prefer to read a book while commuting - but, having foolishly forgotten Where the Hell Is Tuvalu?, I had little else to read on the Tube. Inside, I found something very interesting indeed.

Page 6, underneath something about Trisha and Channel 5, and next to the Top 10 Rental DVDs, was an article the world has been waiting for for years. Nestled within four columns of only twelve lines, Sophie Goodchild tells of the world's first "'cancer-free' baby".

...hang on a moment. A cancer-free baby?

Aren't they all?

"A London woman has given birth to Britain's first child genetically designed to be free of the breast cancer gene," it says.

I'm sorry, but there are many, many things wrong with this article. And I'm not talking about the ethics of such a procedure.

Cancer is an incredibly complicated thing. It is the outcome of the malfunction of any one of thousands of genes and mechanisms in every single cell in the human body. Each of these are required, under normal circumstances, to maintain the body in a perfectly normal and healthy state. Such genes and mechanisms include countless back-up systems to compensate if one goes wrong. Cancer occurs when any one of these mechanisms goes wrong and causes uncontrolled or unchecked growth. There is no one cause. If there were, we'd have come up with a remedy before now. Genetically, cancer can stem from any one of thousands of genes. True, certain genes are more associated with particular types of cancers than others, but there is no such thing as the breast cancer gene.

"A team from London's University College Hospital had screened the woman's embryos and selected those free from a gene which causes breast cancer. ... "The future progeny of this child will be born free of this gene"".

Not once in the article does it mention what gene they are referring to. Nor does it adequately explain that what has really been omitted from this patient is not, in fact, a gene. As for the future progeny of the child being free of this gene, well that depends entirely on who said child marries.

For the answers we have to turn to the proper newspapers and BBC News online, far more respectable science sources. But even then, we need to have an assumed understanding to fully appreciate what was done.

Researchers at UCH screened the fertilised embryos of the couple because the husband's family has a history of breast cancer: three generations of his female relatives all developed breast cancer in their twenties. They all carry the breast cancer 1 (or BRCA1) gene. But, here's the thing. So do you. Everybody has BRCA1. But don't panic - if we didn't have it, there would be many things wrong with us. In fact, we'd all probably have cancer.

What these people have in common is not that they have this gene, but that they all have a specific, mutated form, or allele, of the gene. This mutation is more susceptible to cancer, because it causes BRCA1 to function incorrectly. Thus, the embryos were examined to see which contained the faulty gene, and those that did not were implanted back into the mother in the hope that she would become pregnant. This isn't novel in the world of science - it has been done for diseases such as cystic fibrosis or Huntingdon's disease - nasty illnesses you wouldn't wish on anyone. It provides an alternative to telling parents that they should never have children at all.

BRCA1 is not the only breast cancer gene. There is at least another by name, BRCA2, and many others could cause cancer through misregulation. Removing this allele of BRCA1 from the child does not guarantee that she will never get cancer - merely that one cause has been removed. Any number of genetic and environmental factors could cause cancer later in life. If she started smoking, for example, all the hard work would be undone.

The moral of the story is that this is a remarkable achievement. It certainly deserves a slot better than page 6 (The Times gave it the front page the following day, so full credit to them). It also deserves better reporting.

Remember, there is no such thing as the cancer gene. Cancer sufferers do not have a gene that the rest of us don't - that would mean that they, or us, are not human. They merely have a form that makes them more susceptible to it in later life. That doesn't mean that they will get it.